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Urinary retention is a urologic emergency that is defined by an inability to voluntarily void urine, which can be acute or chronic. Benign inflammatory nervous diseases also cause acute urinary retention, in which patients lack apparent urethral outlet obstruction, but exhibit minor neurological and cerebrospinal fluid (CSF) abnormalities. The development of urinary retention in the context of meningitis and CSF pleocytosis without any lumbosacral radiculomyelitis is known as Meningitis Retention Syndrome (MRS). We report a 24-year-old male with complaints of urine dribbling, fever and also complete urinary retention a few hours later and nausea/vomiting, headache and flank pain. The general and genitalia examinations, routine laboratory tests, diagnostic ultrasound, and brain MRI were normal. But HSV Ab (IgG) and PCR HSV were positive in CSF analysis. Finally, Urologist performed the Urodynamic study and flaccid neurologic bladder was reported due the patient was treated with intravenous acyclovir 500 mg, every eight hours, with the diagnosis of MRS. MRS is a rarely described clinical entity with features of meningitis and acute urinary retention. The most common cause of urinary retention is benign prostatic hyperplasia. Other common causes include prostatitis, cystitis, urethritis, stones, and vulvovaginitis receiving medications in the anticholinergic and alpha-adrenergic agonist classes and cortical, spinal, or peripheral nerve lesions. Since MRS has a benign and self-remitting course, the effectiveness of immune treatments (steroid pulse therapy) remains unclear, although such treatments may shorten the duration of the disease. Management of the acute urinary retention is necessary to avoid renal injury due to hydronephrosis.

     

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